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Chapter-06 Myositis Ossificans

BOOK TITLE: Neglected Musculoskeletal Injuries

Author
1. Jain Anil K
2. Jain Saurabh
3. Sinha Skand
ISBN
9788184488890
DOI
10.5005/jp/books/11171_6
Edition
1/e
Publishing Year
2011
Pages
7
Author Affiliations
1. University College of Medical Sciences and Guru Teg Bahadur Hospital Delhi, India, University College of Medical Sciences and GTB Hospital Delhi, India; Indian Journal of Orthopaedics, University College of Medical Sciences and GTB Hospital Delhi, India Editor, Indian Journal of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
2. University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India, GTB Hospital, Delhi, India, Royal Free Hampstead NHS Trust, London, United Kingdom, Max Super Speciality Hospital, New Delhi, India
3. Ram Manohar Lohia Hospital, New Delhi, India
Chapter keywords

Abstract

Myositis ossificans is defined as benign, localized reactive, non-neoplastic, fibrous, osseous and cartilaginous proliferative lesion within the soft tissue, at times in the periosteum and usually associated with trauma. Injury either direct or indirect remains an important factor in its pathogenesis. Traumatic myositis ossificans is called as myositis ossificans circumscription while when not associated with trauma it is called pseudomalignant myositis ossificans. It can also be caused by extensive burn, immobilization due to coma or paraplegia, severe neurological disorder such as head injury or spinal cord injury. Clinically it could be differentiated into acute or pseudotumoral phase and mature stage. Plain x-ray helps in differentiating the acute and mature stage. CT/MRI show characteristic features in various stages. Biopsy is indicated to rule out osteogenic sarcoma. Among the various characteristic features of myositis ossificans on CT, MRI and USG, there occur considerable overlap with the appearance of malignant tumor and osteomyelitis. Hence a combination of imaging techniques is most useful in differentiating infections and neoplasm from heterotrophic ossification. Conservative treatment is the method of choice in acute stage while surgery to release soft tissue and excise myositis mass is considered in chronic stage.

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